Tachypnea in the Newborn

Tachypnea

Important Concepts

• The most common symptom seen in the nursery
• Retained fluid in lungs takes a while to be absorbed in some babies; especially C-sections and precipitous deliveries are thought to be at higher risk.
• Tachypnea is also seen if baby is:
  • Cold
  • Hypoglycemic (IDM, SGA, LGA)
  • Hypovolemic (Cord issues)
  • Acidotic (any fetal distress?)
  • In meconium aspiration syndrome.
  • Pneumothorax (precipitous delivery, Meconium, PPV?)
  • Polycythemic (IDM, delay in cord clamping?)
  • Cardiac Disease
  • Septic (ROM, GBS, chorio, preterm labor?)
  • Metabolic disease (did sx start after feeding?)

Management Approach

• Check Vitals, Chemstrip, O2 Saturation and cord gases (esp base excess) and consider CBCD, CXR, Blood Gas, Blood culture, Lytes, Glucose
  • Vital signs plus chemstrip
    • make sure infant temp and glucose is normal
    • support with warmer and oxygen as needed
  • Check perfusion
    • Prolonged cap refill may also be due to hypothermia and hypoglycemia
  • Check cord gases if done. Order new gas if needed:
    • Treat acidosis and hypovolemia with 10cc/kg bolus of LR or NS
  • Check for pulses and heart murmur
    • Consider getting BP and sats in all 4 limbs

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This page has been edited 1 times. The last modification was made by - cchou1 on Dec 29, 2009 3:14 pm